Quantitative assessment of the degree of differentiation in colon cancer with dual-energy spectral CT

Chen, Yang; He, Tao; Duan, Haifeng; Jia, Yongjun; Zhang, Xirong; Ma, Genshan; Ren, Chao; Wang, Jun; Yan, Yu

doi:10.1007/s00261-017-1176-6

Cited by 36 publications

(28 citation statements)

References 22 publications

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“…In addition, nICPP has been reported to exert a high sensitivity in differentiating malignant gastric mucosal lesions from normal gastric mucosa [ 11 ]. Furthermore, studies on the diagnostic efficacy of tumor differentiation degree are inconsistent [ 35 , 36 ], which may be due to the different biological behaviors of tumors and degrees of differentiation. A previous study has found that the values of IC and nIC of poorly differentiated adenocarcinoma are not significantly different compared to those of moderately and well-differentiated adenocarcinomas in AP [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Detection of gastric cancer and its histological type based on iodine concentration in spectral CT

Wang

et al. 2018

Cancer Imaging

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BackgroundComputed tomography (CT) imaging is the most common imaging modality for the diagnosis and staging of gastric cancer. The aim of this study is was to prospectively explore the ability of quantitative spectral CT parameters in the detection of gastric cancer and its histologic types.MethodsA total of 87 gastric adenocarcinoma (43 poorly and 44 well-differentiated) patients and 36 patients with benign gastric wall lesions (25 inflammation and 11 normal), who underwent dual-phase enhanced spectral CT examination, were retrospectively enrolled in this study. Iodine concentration (IC) and normalized iodine concentration (nIC) during arterial phase (AP) and portal venous phase (PP) were measured thrice in each patient by two blinded radiologists. Moreover, intraclass correlation coefficient (ICC) was used to assess the interobserver reproducibility. Differences of IC and nIC values between gastric cancer and benign lesion groups were compared using Mann-Whitney U test. Furthermore, the gender, age, location, thickness and histological types of gastric adenocarcinoma were analyzed by Mann-Whitney U test or Kruskal-Wallis H test. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of IC and nIC values, and the optimal cut-off value was calculated with Youden J.ResultsAn excellent interobserver agreement (ICC > 0.6) was achieved for IC. Notably, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in gastric cancer group (Z = 5.870, 3.894, 2.009 and 10.137, respectively; P < 0.05) than those in benign lesion group. Additionally, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in poorly differentiated gastric adenocarcinoma group (Z = 4.118, 5.637, 6.729 and 2.950, respectively; P < 0.005) than those in well-differentiated gastric adenocarcinoma group. There were no statistically significant differences in the values of ICAP, ICPP, nICAP and nICPP between age, gender, tumor thickness and tumor location. Furthermore, the area under the curve (AUC) values of ICAP, nICAP, ICPP and nICPP were 0.745, 0.584, 0.662, and 0.932, respectively, for gastric cancer detection; while 0.756, 0.919, 0.851 and 0.684, respectively, in discriminating poorly differentiated gastric adenocarcinoma.ConclusionIC values exhibited great potential in the preoperative and non-invasive diagnosis of gastric cancer and its histological types. In particular, nICPP is more effective for the identification of gastric cancer, whereas nICAP is more effective in discriminating poorly differentiated gastric adenocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Detection of gastric cancer and its histological type based on iodine concentration in spectral CT

Wang

et al. 2018

Cancer Imaging

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Section: Resultsmentioning

confidence: 99%

“…Two studies demonstrated a significant difference in IC between poorly and moderate/well-differentiated colorectal cancer [ 48 , 49 ]. Chuang-bo et al [ 49 ] only found a significant difference during the arterial phase, while Gong et al [ 48 ] reported a significant difference in both the arterial and the venous phase. Similar to the gastric cancer studies [ 42 , 45 ], a positive correlation between IC and pathological grading of rectal cancer prior and following chemoradiotherapy treatment was reported [ 50 ].…”

Section: Resultsmentioning

confidence: 99%

“…Similar to gastric and colorectal cancer, Ge et al [ 59 ] demonstrated a positive correlation among esophageal cancer patients between nIC and response following chemoradiotherapy based on response criteria in solid tumors (RECIST) criteria. Unlike the studies in the gastric and colorectal group [ 36 , 48 , 49 ], two studies [ 31 , 60 ] suggested that IC/nIC can differentiate between specific cancer subtypes such as squamous cell carcinoma and adenocarcinoma in the gastroesophageal junction, as well as discriminate between small bowel adenocarcinoma and primary small intestine lymphoma. Additionally, Zhang et al [ 32 ] found a significant difference in IC between high- and moderate/low-risk GIST patients based on GIST recurrence risk stratification criteria [ 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…An additional finding was the correlation between IC and varying degrees of cell differentiation in adenocarcinoma. Two colorectal cancer and five gastric adenocarcinoma studies [ 36 , 37 , 38 , 39 , 41 , 48 , 49 ] demonstrated an overall positive correlation between IC/nIC and the degree of differentiation, when the ROI was placed within the tumor mass as shown in Table 1 and Table 2 . These studies had an overall low risk of bias ( Figure S1 ).…”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review

Taudorf

Ulriksen

et al. 2020

Diagnostics

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Dual-energy computed tomography (DECT) can estimate tissue vascularity and perfusion via iodine quantification. The aim of this systematic review was to outline current and emerging clinical applications of iodine quantification within the gastrointestinal tract using DECT. The search was conducted with three databases: EMBASE, Pubmed and The Cochrane Library. This identified 449 studies after duplicate removal. From a total of 570 selected studies, 30 studies were enrolled for the systematic review. The studies were categorized into four main topics: gastric tumors (12 studies), colorectal tumors (8 studies), Crohn’s disease (4 studies) and miscellaneous applications (6 studies). Findings included a significant difference in iodine concentration (IC) measurements in perigastric fat between T1–3 vs. T4 stage gastric cancer, poorly and well differentiated gastric and colorectal cancer, responders vs. non-responders following chemo- or chemoradiotherapy treatment among cancer patients, and a positive correlation between IC and Crohn’s disease activity. In conclusion, iodine quantification with DECT may be used preoperatively in cancer imaging as well as for monitoring treatment response. Future studies are warranted to evaluate the capabilities and limitations of DECT in splanchnic flow.

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Discriminating atypical parotid carcinoma and pleomorphic adenoma utilizing extracellular volume fraction and arterial enhancement fraction derived from contrast‐enhanced CT imaging: A multicenter study

Xu,

Huang,

Yang

et al. 2024

Cancer Medicine

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ObjectivesTo investigate the added value of extracellular volume fraction (ECV) and arterial enhancement fraction (AEF) derived from enhanced CT to conventional image and clinical features for differentiating between pleomorphic adenoma (PA) and atypical parotid adenocarcinoma (PCA) pre‐operation.MethodsFrom January 2010 to October 2023, a total of 187 cases of parotid tumors were recruited, and divided into training cohort (102 PAs and 51 PCAs) and testing cohort (24 PAs and 10 atypical PCAs). Clinical and CT image features of tumor were assessed. Both enhanced CT‐derived ECV and AEF were calculated. Univariate analysis identified variables with statistically significant differences between the two subgroups in the training cohort. Multivariate logistic regression analysis with the forward variable selection method was used to build four models (clinical model, clinical model+ECV, clinical model+AEF, and combined model). Diagnostic performances were evaluated using receiver operating characteristic (ROC) curve analyses. Delong's test compared model differences, and calibration curve and decision curve analysis (DCA) assessed calibration and clinical application.ResultsAge and boundary were chosen to build clinical model, and to construct its ROC curve. Amalgamating the clinical model, ECV, and AEF to establish a combined model demonstrated superior diagnostic effectiveness compared to the clinical model in both the training and test cohorts (AUC = 0.888, 0.867). There was a significant statistical difference between the combined model and the clinical model in the training cohort (p = 0.0145).ConclusionsECV and AEF are helpful in differentiating PA and atypical PCA, and integrating clinical and CT image features can further improve the diagnostic performance.

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Quantitative assessment of the degree of differentiation in colon cancer with dual-energy spectral CT

Abstract: Spectral CT imaging parameters (IC, NIC, and λ ) in AP provide improved accuracy for evaluating the degrees of differentiation in colon cancer than CT number at 70 keV.

Cited by 36 publications

References 22 publications

Detection of gastric cancer and its histological type based on iodine concentration in spectral CT

Detection of gastric cancer and its histological type based on iodine concentration in spectral CT

Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review

Discriminating atypical parotid carcinoma and pleomorphic adenoma utilizing extracellular volume fraction and arterial enhancement fraction derived from contrast‐enhanced CT imaging: A multicenter study

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